Clinical trial

Pilot Study to Assess Impact of Kuvan® Supplementation as an Adjunct Treatment in Subjects With Dominantly-inherited GTPCH Deficiency on Mood, Behavioral and Motor Phenotypes

Name
48052
Description
The purpose of this study is to identify the dose of Kuvan needed to normalize the levels of tetrahydrobiopterin (BH4) in patients with a Guanosine Triphosphate Cyclohydrolase (GTPCH) deficiency and to asses the potential impact of oral Kuvan on mood and function in individuals with GTPCH deficiency who may be experiencing symptoms of anxiety, depression, fatigue, trouble concentrating, or memory loss. This will be a phase one study. The investigators will monitor patients over a period of three to six months while on the medication. Medication levels will be monitored by measuring the BH4 levels in cerebral spinal fluid (CSF). Patients will undergo a baseline lumbar puncture and two follow-up lumbar punctures for this purpose. The investigators will also monitor emotional function and motor function.
Trial arms
Trial start
2011-08-01
Estimated PCD
2013-08-01
Trial end
2013-08-01
Status
Completed
Phase
Early phase I
Treatment
Sapropterin
Sapropterin will be taken daily for 12 or 24 weeks. Starting dose will be 20mg/kg/day and will increase at the 8 week visit to 30 mg/kg/day. Dosing may be further increased to as high as 40 mg/kg/day in attempt to normalize BH4 levels in CSF. Starting dose for Cohort 2 will be determined from data analysis in Cohort 1.
Arms:
Kuvan Cohort 1, Kuvan Cohort 2
Other names:
Kuvan
Size
12
Primary endpoint
Change in BH4 Levels in Cerebral Spinal Fluid
Baseline, 8 wks, 12 wks
Change in Neurotransmitter Metabolite Levels in Cerebral Spinal Fluid
Baseline, 8 wks, 12 wks
Eligibility criteria
Inclusion Criteria: * established diagnosis of GTPCH deficiency, supported by appropriate family history, CSF neurotransmitter studies, skin fibroblast enzyme assay and/or mutation analysis * minimum age 18 years * identified by self or others to have symptoms of anxiety, depression, fatigue, or other neurocognitive dysfunction (trouble concentrating, memory loss, etc) * willingness to undergo at least 2 CSF evaluations for BH4 and neurotransmitter levels over an 8 to 12 week period Exclusion Criteria: * age \< 18 years old * unwillingness to undergo repeated CSF analysis * lack of supporting diagnostic criteria * concomitant medical problems or medications which would increase risk of Kuvan® * concomitant psychiatric state, such as severe depression with suicidal ideation that requires immediate referral and alternative treatment intervention * prior history of back surgery, abnormality or chronic pain that in the opinion of the investigator would increase risks associated with lumbar puncture * significant obesity that might increase difficulty or risk in performing lumbar puncture * if female, unwillingness to use birth control during the period of study drug administration
Protocol
{'studyType': 'INTERVENTIONAL', 'phases': ['PHASE1', 'PHASE2'], 'designInfo': {'allocation': 'NON_RANDOMIZED', 'interventionModel': 'SINGLE_GROUP', 'primaryPurpose': 'TREATMENT', 'maskingInfo': {'masking': 'NONE'}}, 'enrollmentInfo': {'count': 12, 'type': 'ACTUAL'}}
Updated at
2023-06-02

1 organization

1 product

1 indication

Organization
University of Utah